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Outpatient Infusion Authorization Nurse

1 month ago

St Genevieve, Missouri, United States Ste Genevieve County Memorial Hospital Full time
Job Title: Outpatient Infusion Authorization Nurse

Ste Genevieve County Memorial Hospital is seeking a highly skilled Outpatient Infusion Authorization Nurse to join our team. As a key member of our Oncology department, you will be responsible for reviewing prior authorization requests, verifying insurance benefits, and performing complex pre-certifications for oncology regimens and specialty drugs.

Key Responsibilities:

  • Review and verify insurance benefits for requested chemotherapy, specialty infusions, and injections
  • Perform complex pre-certifications for oncology regimens and specialty drugs
  • Document all pertinent authorization information in Meditech and communicate updates or issues with clinical staff and providers
  • Collaborate with Oncology staff and doctors to obtain complete, accurate, and timely clinical and financial information required for payer reimbursement
  • Manage and oversee insurance denials, appeals, and peer-to-peer reviews through to resolution

Requirements:

  • RN, LPN, or other related clinical experience
  • Previous insurance coding and billing experience required
  • Previous experience and knowledge of insurance authorization and verification process for major medical insurance plans and all Federal, State, and 3rd party payers required

Ste Genevieve County Memorial Hospital is an equal opportunity employer and welcomes applications from qualified candidates.